B Y I V O D R U R Y, M D , M B A
DOES
md+mba=
Careful review of your rationale and the range of program options
and demands are key considerations before you enter the classroom.
D
R. CHRISTINE GUICO-PABIA
MD, MBA, MPH, the direc-
tor of neuroscience global
medical affairs for Wyeth
Pharmaceuticals, was in the
vanguard of physicians adding formal
management training to their MDs
when she obtained an MBA degree at
Temple University 16 years ago. She
sought the degree to complement her
background in public service and saw
an MBA (master of business adminis-
tration) as the next step in the evolu-
tion of her career. In a 15-year career
in the pharmaceutical industry since
earning her MBA, she credits her de-
gree with “shifting the way I thought
which allowed me to bring in fresh
ideas” combining medical and business
perspectives and adding credibility
with non-physician business colleagues.
She singles out the value of her busi-
ness training in teaching her how to
position her point of view for her spe-
cial interest—developing and deliver-
ing health-care technologies.
Lauren M., a 35-year old emergency
room physician, wanted to return to
1 Sept/Oct 2007 Unique Opportunities® The Physician’s Resource
HAPPINESS AND SUCCESS?
medicine in a new role after four years
as a stay-at-home mother. Two col-
leagues’ suggestions of getting an
MBA led her to seek the opinion of an
independent adviser. Discussions
quickly clarified that she had no clear
rationale behind obtaining an MBA,
though she undoubtedly would have
been accepted and prospered in such a
program. Rather, she nursed a private
wish to be a psychiatrist, a career op-
tion she had rejected earlier as it was
her father’s field of practice. She en-
tered a second residency in psychiatry
at a .8 FTE basis to allow her meet her
family responsibilities and is now thriv-
ing in the second year of her program.
Whether it’s for career advancement
or greater variety, many physicians
consider opportunities to expand their
professional roles. Daily life at the hos-
pital or clinic exposes us to some or all
of the following:
* We are part of the health-care industry,
surrounded by layers of bureaucracy
and a strict regulatory environment.
* Our institutions may employ large
numbers of younger administrative
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persons with MBA degrees who claim
to have all the answers.
* We note that the MD/MBA
combination, while uncommon, is
certainly no longer rare.
Quite reasonably, therefore, many
physicians ask whether formal training
in business and management would
open up new career options.
In mid-career, at age 47, and while
serving as a chair of a neurology
department, I obtained an MBA. I’ve
been actively involved in physician
management both before and since
receiving the MBA, and after the
degree in the development of startup
companies and as an adviser to
industry. When asked by physician
colleagues about the merits and
practicalities of heading back to the
classroom, I say that background
research falls under three main
considerations:
* Critical examination of your rationale
for acquiring an MBA
* Knowing the range of program options
available to you

* Knowing what you should expect
once the program is under way
Working through these considera-
tions will help ensure that your deci-
sion to proceed is a thoughtful, well-
researched one with the greatest like-
lihood that this new qualification will
add real value to your professional
life and future career opportunities.
Examine your rationale
Drill down into your reasons to
pursue an MBA:
* What’s driving your desire for career
change and development? Are these
influences more a move away from
some feature of your professional life
or a move toward some particular
goal?
* How do you envision an MBA degree
will open up new career avenues, and
are there alternate routes to consider?
* Will you be open to unanticipated
“byproducts” of your MBA education?
If you elect to get an MBA degree
as a way around feeling stuck or disil-
lusioned with clinical medicine, you
2 Sept/Oct 2007 Unique Opportunities® The Physician’s Resource
are short-circuiting the process of
putting your career under the micro-
scope. You would do better to exam-
ine your professional and personal
options thoroughly, focus on a limited
number of target choices, then de-
cide whether or how an additional
degree would be helpful. Don’t ex-
pect novel ideas about how to spend
the second half of your medical ca-
reer to emerge in an accounting class.
Keep in mind that it is part of our
professional culture as physicians to
place a high value on formal qualifi-
cations. Classrooms are familiar,
comfortable environments where we
have already displayed the ability to
succeed.
Kent Bottles agrees there is noth-
ing automatically transforming about
adding the letters “MBA” to your cre-
dentials. “There’s a tendency for
physicians disenchanted with medical
practice to think there’ll be a magic
to getting an MBA” says Bottles, the
vice-president and the chief medical
officer of the Iowa Health System.
Bottles has worked as an academic
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Kevin Ruggles, MD,
the chief physician
executive of Rockford
Health Physicians in
Rockford, Illinois,
holds a master’s of
medical management
(MMM). “Practices
with strong physi-
cian-centric cultures
are places where you
have to prove yourself
with years of clinical
experience before
you can ascend to
management or exec-
utive roles, and
where that back-
ground counts for
more than an addi-
tional degree.”
pathologist, a biotechnology compa-
ny executive, and a CEO of a med-
ical education and research consor-
tium. He proposes that if you want to
reinvent yourself, you would do bet-
ter to take stock of what you don’t
like about your current situation
rather than head to the classroom.
There are scores of fine business
minds among physicians in every
arena of health care who don’t have
formal business or management
training. The more you stay in the
mainstream of health care and par-
ticularly with one organization or
practice during your career, the less
need will there be for additional qual-
ifications. In fact, in some practice
cultures, clinical experience counts
more. Kevin Ruggles, MD, the chief
physician executive of Rockford
Health Physicians in Rockford,
Illinois, also holds a master’s of med-
ical management (MMM). He was
previously a staff neurologist and a
physician executive at the Marshfield
Clinic in Marshfield, Wisconsin, and
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 MD + MBA = Happiness and Success?
Continued from previous page
he says, “Practices with strong physi-
cian-centric cultures are places where
you have to prove yourself with years of
clinical experience before you can as-
cend to management or executive roles,
and where that background counts for
more than an additional degree.”
In addition, an MBA—of itself—will
not make you an expert in finance, mar-
keting, or accounting. An MBA is a gen-
eral business degree providing you ex-
posure to a wide range of business disci-
plines. In this way, it’s like your medical
degree. After graduation from med
school, you had to pick your specialty
and go through residency training, and
graduates of full-time MBA programs
commonly go through extensive on-the-
job training in the intricacies of finance
or marketing after they start on Wall
Street or Madison Avenue.
Physicians considering a career in in-
dustries like medical insurance or phar-
maceuticals sometimes believe that hav-
ing an MBA will make them a more at-
tractive job candidate. However, it is
your medical degree, specialty training,
and clinical experience that remain the
cornerstone of your application. If you
are employed in these fields and desire
the qualification, you may find that se-
nior executives will sponsor your MBA
if this is mutually advantageous.
Before enrolling, check your rationale
with colleagues who already have had
an MBA for several years. Ask about
their original purpose for obtaining the
degree, how it advanced their career
progression, and whether the degree
took their career in a different direction
than they originally envisioned. The
usefulness of an MBA “settles” over sev-
eral years, making discussions with vet-
eran holders of the degree more valu-
able.
In my case, I’m much more involved
now in human resource issues for physi-
3 Sept/Oct 2007 Unique Opportunities® The Physician’s Resource
POINTS TO PONDER
* RATIONALE - How will an MBA facilitate
new professional opportunities or alternate
career roles in your existing practice? Do a
reality check with colleagues who’ve ob-
tained MBAs at different institutions and for
diverse purposes.
* FINANCIAL COST - Tuition costs range
from $40,000 to $90,000; factor other
costs like travel, lodging, and costs
of lost income. Any employer tu-
ition support may be imputed income.
* LOCATION OF PROGRAM - Learning
may be at local schools, involve consid-
erable travel, or be primarily electronic.
Weigh the added stress and time for travel
and your comfort with e-learning. Team-
based projects will prove more feasible with
local schools.
* LEARN WITH PHYSICIANS OR OTHERS -
Physician-exclusive MBAs or MMMs
enhance intra-health-care networking
opportunities, contain more health-care
industry case discussion, and offer CME
credit. General MBA programs provide
broader variety in case exposure and
classmate background.
cians rather than the heavily quantita-
tive roles in health economics and fi-
nance that initially drew me to the class-
room. In another example, Bertrand
Liang, a neuro-oncologist by training
and now the board chairman of Tracon
Pharmaceuticals, Inc. and the vice
chairman of Paramount BioSciences,
both in San Diego, says his MBA de-
gree “opened up worlds that I’d never
have perceived.” He developed particu-
lar interests in finance and corporate
strategy during his training and runs a
financial services group that funds
biotechnology ventures.
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* ADVANCE PREPARATION - While most pro-
grams waive the GMAT for physicians, you
will find that comfort with e-learning (even at
local schools), Internet usage, EXCEL, and
statistics are de facto prerequisites.
* IN-PROGRAM TIME COMMITMENT - Most
established physicians enroll in an execu-
tive-style MBA while continuing practice.
Course durations average 15 to 21 months
with typical total on-campus classroom time
of four to 12 weeks and weekly homework of
approximately 20 hours. Weigh pros and
cons of structured program or flex-learning
with constraints of your existing responsibili-
ties and self-discipline about course comple-
tion. Full-time programs are typically consid-
ered by younger physicians placing their
medical degree in a secondary role in future
career planning.
* INTELLECTUAL CHALLENGE - Some
coursework, especially quantitatively-intense
material, can be quite challenging.
* MINDING FRIENDS AND FAMILY - Ensure
support from your family and practice col-
leagues before you begin the program and
commit to sustain it during the training.
Know the range of program options
Secure with your rationale as to the
added value of an MBA, you must then
choose from the wide range of program
options available. Your ultimate choice
will come down to a set of tradeoffs—
though each style of program has its
proponents, final choices are driven
more by the constraints of your existing
personal and professional realities,
rather than there being one type of pro-
gram that is intrinsically superior.
While full-time MBA programs
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MD + MBA = Happiness and Success?
Continued from previous page
Median Compensation of Physician Executives by Post-Graduate Business Management Degree and Position
From the 2005 Physician Executive Compensation Survey, published by Cejka Search and the American College of Physician Executives (ACPE).
No Degree
All Physician Executives $239,000
Assoc/Asst Medical Director 205,000
CEO/President 323,250
Dept/Division Chair/Mgr 265,000
Medical Director 225,000
VP of Medical Affairs 235,000
Chief Operations Officer 256,000
Reprinted with permission from Cejka Search. Information is based on responses from 2,422 ACPE members nationwide.
abound, part-time programs are most
popular with physicians because they
allow you to continue to practice.
Programs may be completed at local ed-
ucational institutions or at considerable
distance. Of course, universities farther
away have ancillary costs such as travel
and hotel accommodation, and more
time away from family and work. All
programs include some component of
e-learning, and for some (including
physician specific programs) the per-
centage approaches 100 percent. For
Liang, who completed his degree at
Regis University in Denver, 80 percent
of the program was e-based and al-
lowed for flexible course duration. The
greater the course duration and flexibili-
ty available, the more discipline is re-
quired to complete the training.
In addition to general MBAs, there
are MBA programs exclusive to physi-
cians as well as MBA-like degrees, such
as the MMM. Most full-time MBA and
MMM programs take two years to com-
plete. Physician-exclusive programs are
designed to be part time. One benefit of
physician-exclusive programs is that
CME may be earned while enrolled.
Charles Guernsey, DO, MBA, the
4 Sept/Oct 2007 Unique Opportunities® The Physician’s Resource
MBA MMM
$250,000 $250,000
232,000 220,000
340,000 310,000
290,000 282,500
225,000 228,000
255,000 239,500
281,400 184,000
medical director of Southern Michigan
Pain Consultants in Kalamazoo,
Michigan and an associate professor at
the College of Osteopathic Medicine of
Michigan State University, recently com-
pleted the one-year-long MBA program
for physicians at the University of
Tennessee in Knoxville. He favored a
physician-exclusive program because he
is focused on health care and wanted to
contribute to health-care policy. With
heavy practice commitments, it was also
important for him to be involved in a
program with “defined goals and timeta-
bles giving me structure and discipline.”
The MMM degree has been avail-
able through the American College of
Physician Executives (ACPE) since
1997 and involves completing pro-
grams in medical management through
ACPE followed by additional course-
work at one of three business schools
(Carnegie-Mellon University, Tulane
University, or the University of
Southern California). Ruggles pursued
his MMM degree at USC because “I’d
already completed several ACPE
courses, so it was logistically easier and
less expensive. Also, I knew where I
wanted to go with the rest of my ca-
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MPH MHA JD
$220,000 $250,000 $237,000
180,000 - -
225,000 358,500
250,000 340,000 -
208,500 225,500 205,000
238,000 - -
275,000 - 500,000
reer.”
A distinct plus of physician-exclusive
MBA programs is the networking op-
portunities they present. Guernsey saw
great benefit from networking, feeling
he’d developed “professional friends for
life” and was delighted that his pro-
gram had active alumni group meet-
ings. Other dual-degreed physicians say
there are also benefits to being in pro-
grams with non-medical MBA stu-
dents. Bottles says physicians “have
much to learn from industries like air-
lines and hotels.” Case studies from
these industries are more frequently
discussed in general MBA programs
than those that are physician exclusive.
Know what’s involved
Once you have identified one or two
educational programs to which you feel
most suited, you must consider several
practical hurdles. Evaluation of these
potential roadblocks will allow you to
complete your degree while sustaining
your personal and current professional
activities and avoid any of those “well,
I never thought about that” moments.
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MD + MBA = Happiness and Success?
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* ADVANCE TESTING AND PREPARATION.
GMATs, the business school equivalent
of the MCATs, will usually be waived.
Program directors feel the demands of
your undergraduate and graduate med-
ical training already indicate you possess
the intellectual capacity and self-disci-
pline to successfully complete the course
requirements. As a prospective MBA
student you should be comfortable with
e-learning and Internet usage.
Knowledge of statistics, and an under-
standing of software programs like Excel
and PowerPoint are also prerequisites. If
you fail to master Excel or brush up on
statistics before starting the MBA in the
belief that you’ll “wing it,” you’ll be
sorry. The pace of learning is fast, the
assignments come week after unceasing
week. Don’t expect sympathy for your
life as a busy physician
* COST
You should anticipate tuition costs of
$40,000 to $90,000 spread over the dura-
tion of the program. This includes books
and special software programs, but not the
cost of particular features of some pro-
grams. Remember to factor other costs
like travel, lodging, and meals, and the
cost of lost income while you are not at
your practice. Tuition support may be
available from your employer—clarify the
tax implications with an accountant as this
may constitute imputed income.
* COURSE DURATION AND TIME
COMMITMENTS
Course durations vary from one to two
years, most requiring some on-campus
class time. I completed the Weekend
MBA program at Michigan State
University’s Broad Graduate School of
Management. On campus time commit-
ments were three full weeks and 35
weekends (with 12 hours of classes from
5 Sept/Oct 2007 Unique Opportunities® The Physician’s Resource
4pm Friday to 5pm Saturday) over 17
months. Most weeks required about an
additional 20 hours of self study, assign-
ment completion and a three- to four-
hour face-to-face meeting with three
teammates who lived nearby. This is
representative of the time commitments
required at many programs around the
country for students trying to get maxi-
mum value from their experience.
* INTELLECTUAL CHALLENGE
While you’ll be well up to the intellectu-
al demands of a graduate business de-
gree, you should anticipate that some
course work, especially the quantitative-
ly intense material, will prove challeng-
ing—there may be more than one rea-
son for economics being called the dis-
mal science. “I was able to gain mastery
of finance, statistics, and the on-line
marketplace simulation, but only with a
significant time penalty,” says Guernsey.
Other physician colleagues describe the
challenging courses as “humbling.”
* REACTIONS OF COLLEAGUES
Annual expenditures on health care within
the United States may be at $1.7 trillion,
but the culture of the medical profession is
one still uneasy at accepting the business
dimension to our patient care work.
Physicians are almost reflexively skeptical
of colleagues who choose to acquire for-
mal business or management training. I
encourage meeting that skepticism head
on-the best interests of both our patients
and professional colleagues can be a pri-
mary driver for a physician to acquire an
MBA. What’s more, the qualifications do
complement one another. Your colleagues
will feel affected even if their actual work-
load does not change. They, like our fami-
lies, are entitled to know what we are em-
barking on, and the legitimacy of their
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opinions should be acknowledged.
Transient discomfort in a collegial rela-
tionship is preferable to being perceived as
a deceitful.
* MINDING FRIENDS AND FAMILY
Your MBA program, however demand-
ing, will end, but life with your
spouse/partner, children, and other
family and friends continues. When con-
sidering an MBA, reflect on how to inte-
grate such a sizeable time commitment
into your professional and family lives.
You should seek and obtain the willing
support of your loved ones before you
commence the program, allow time for
them throughout the course, and cele-
brate your completing the degree by re-
warding them in some particular way.
Overall, formal business and manage-
ment training offers opportunities to ex-
pand your professional role, interact more
effectively with senior non-physician ad-
ministrators in their practice, and advance
your career in ways you may or may not
anticipate. Positive returns from acquiring
the degree are most likely to occur when
you critically assess your rationale with the
aid of seasoned colleagues and know what
you (and your family) are committing to
before you cross the threshold of an MBA
classroom. I
Ivo Drury, MD, MBA advises physicians considering
career transitions. A board-certified neurologist, he
practiced at academic medical centers for 26 years
and has experience as a physician executive in mul-
tiple capacities. He may be reached through
www.career-consulting-physicians.com.